antioxidants in kidney diseases the impact of bardoxolone methyl抗氧化剂在肾脏疾病bardoxolone甲基的影响.pdfVIP

Hindawi Publishing Corporation International Journal of Nephrology Volume 2012, Article ID 321714, 11 pages doi:10.1155/2012/321714 Review Article Antioxidants in Kidney Diseases: The Impact of Bardoxolone Methyl Jorge Rojas-Rivera, Alberto Ortiz, and Jesus Egido Laboratory of Renal and Vascular Pathology, Division of Nephrology and Hypertension, IIS Fundacion Jimenez Dıaz, ´ ´ ´ Autonoma University of Madrid, 28040 Madrid, Spain Correspondence should be addressed to Jorge Rojas-Rivera, jerori2003@ Received 15 September 2011; Revised 2 April 2012; Accepted 10 April 2012 Academic Editor: Ali Anarat Copyright © 2012 Jorge Rojas-Rivera et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Drugs targeting the renin-angiotensin-aldosterone system (RAAS) are the mainstay of therapy to retard the progression of proteinuric chronic kidney disease (CKD) such as diabetic nephropathy. However, diabetic nephropathy is still the first cause of end-stage renal disease. New drugs targeted to the pathogenesis and mechanisms of progression of these diseases beyond RAAS inhibition are needed. There is solid experimental evidence of a key role of oxidative stress and its interrelation with inflammation on renal damage. However, randomized and well-powered trials on these agents in CKD are scarce. We now review the biological bases of oxidative stress and its role in kidney diseases, with focus on diabetic nephropathy, as well as the role of the Keap1-Nrf2 pathway and recent clinical trials